Early COVID-19 vaccine demand will far exceed supply and so states have been refining distribution plans for months. Here is a topline review of what to expect.
With the chaotic and insufficient distribution of testing supplies and PPE still top of mind and a clear understanding that early vaccine demand will far exceed the supply, states months ago began to develop vaccine distribution plans to target high-priority populations while incorporating evolving federal recommendations.
As of October 2020, no 2 states had prioritized their populations in precisely the same way, according to an analysis by the National Academy for State Health Policy (NASHP). Most allocation plans incorporate CDC and other federal guidance and many states refine strategies based on interstate advisory boards.
How state distribution plans may vary
Number of phases. Number may vary, from 2 to 5. Most have 3 or 4 with some subcategorized further into A, B, and C.
Delineation of phases. As of early December, some states had only identified Phase 1 populations while waiting for additional federal or interstate guidance.
Priority group size. About 40% of states have reported number of individuals in each priority population; details could influence distribution plans. Mapping and other software will identify locations of priority populations.
Specific high-risk populations. Some states include racial/ethnic minority groups, tribal and rural populations within a specific phase. Others will recruit vaccine providers in underserved areas but do not list groups as targeted.
Nuance of priority populations. Delineation differs within phases, eg, some states group essential workers, or congregate care residents, in one phase. Others may prioritize congregate care residents aged ≥65 years vs those younger living in homeless shelters or prisons.
Despite variations, all 50 states and Washington, DC have prioritized healthcare workers, placing them in Phase 1 distribution. Below, flash cards define phases and priority populations.
PHASE 1. Limited COVID-19 vaccine doses available.
Key considerations: Vaccine supply is limited. Distribution is concentrated on critical populations with prioritization in each phase (eg, Phase 1a, 1b, 1c). Inventory and distribution will be closely monitored and reported to state and federal tracking systems.
PHASE 2. Larger supply of doses are available, with supply expected to meet demand.
Key considerations: Larger vaccine supplies allow for expanded vaccine administration sites. Expanded vaccine access allows for equitable distribution.
PHASES 3 TO 5. Sufficient supplies available.
Key considerations: At this point, supply is expected to exceed demand. States should have a broad vaccine network established to ensure access.
HEALTHCARE WORKERS: Following federal recommendations,
every state and Washington, DC plans to vaccinate health care workers during Phase 1.
LONG-TERM CARE RESIDENTS. Of the 44 states that included residents in their October vaccine distribution plans, 40 plan to vaccinate them during Phase 1, which the Advisory Committee on Immunization Practices recently recommended. Other states may update their plans to reflect ACIP recommendations.
TEACHERS AND CHILDCARE PROVIDERS. Of 38 states that addressed these sectors, 22 reported they plan to vaccinate them in Phase 1, 13 said they plan to vaccinate them in Phase 2, and three states plan to vaccinate teachers and childcare providers in Phase 3.
OTHER KEY POPULATIONS. Incarcerated populations & correctional officers. Usually in phase 1 or 2. Nine states plan to vaccinate incarcerated people at some point in Phase 1, 27 states plan to vaccine incarcerated people in Phase 2, and two states plan to vaccinate them in Phase 3. In contrast, 10 states plan to vaccinate correctional officers in Phase 1, and 13 states have plans to do so in Phase 2.